The Impact of Endometriosis on Embryo Quality in in-vitro Fertilization/Intracytoplasmic Sperm Injection: A Systematic Review and Meta-Analysis

Background: The association between endometriosis and embryological outcomes remains uncertain. The meta-analysis aimed to evaluate the impact of endometriosis on embryo quality. Methods: A systematic review and meta-analysis was conducted to investigate the association between the endometriosis and embryo quality. Searches were performed on the three electronic databases: PubMed, EMBASE, and Web of Science. The detailed characteristics and data of the included studies were extracted. The risk ratio with 95% confidence intervals were calculated using the random and fixed effects model. The main outcome measures were high-quality embryo rate, cleavage rate, and embryo formation rate. Results: A total of 22 studies included were analyzed. Compared with the control group, women with endometriosis had a similar high-quality embryo rate (RR = 1.00; 95% CI, 0.94-1.06), a comparable cleavage rate (RR = 1.00; 95% CI, 0.97-1.02), and a similar embryo formation rate (RR = 1.10; 95% CI, 0.97-1.24). In women with stage III-IV endometriosis, there was no statistically significantly difference in high-quality embryo rate (RR = 1.02; 95% CI, 0.94-1.10), cleavage rate (RR = 1.00; 95% CI, 0.98-1.02), and embryo formation rate (RR = 1.05; 95% CI, 0.97-1.14), compared with those without endometriosis. For women with unilateral endometrioma, pooling of results from the affected ovaries did not show a statistically significantly difference in high-quality embryo rate (RR = 0.99; 95% CI, 0.60-1.63) in comparison to the normal contralateral ovaries. Conclusions: Our results seem to indicate that endometriosis does not compromise embryo quality from the perspective of morphology.

Automated summary

The study found no significant association between endometriosis and embryo quality, with no differences observed in high-quality embryo rate, cleavage rate, and embryo formation rate in overall analysis as well as subgroup analyses based on the severity of endometriosis or ovarian cysts.